Intensive care medicine
-
Intensive care medicine · Aug 2006
Randomized Controlled Trial Multicenter Study Comparative StudyEarly enteral immunonutrition vs. parenteral nutrition in critically ill patients without severe sepsis: a randomized clinical trial.
We compared early parenteral nutrition (PN) and early enteral immunonutrition (iEN) in critically ill patients, distinguishing those with and without severe sepsis or septic shock (SS) on admission to intensive care units (ICUs). ⋯ Compared to parenteral nutrition iEN appears to be beneficial in critical patients without severe sepsis or septic shock. Parenteral nutrition in these patients should be abandoned, at least when enteral nutrition can be administered, even at an initial low caloric content.
-
Intensive care medicine · Aug 2006
Meta AnalysisQuality of life after acute respiratory distress syndrome: a meta-analysis.
To summarize long-term quality of life (QOL) and the degree of variation in QOL estimates across studies of acute respiratory distress (ARDS) survivors. ⋯ ARDS survivors in different clinical settings experience similar decrements in QOL. The precise magnitude of these decrements helps clarify the long-term prognosis for ARDS survivors.
-
Intensive care medicine · Aug 2006
Multicenter StudyOutcome value of Clara cell protein in serum of patients with acute respiratory distress syndrome.
Injury to the alveolocapillary barrier characterizes ALI/ARDS; therefore determining levels of lung epithelium-specific small proteins in serum may help predict clinical outcomes. We examined whether serum Clara cell protein (CC-16) concentration is correlated with the outcome, mechanical ventilation duration, and incidence of nonpulmonary organ failure. ⋯ Higher initial CC-16 serum level is associated with increased risk of death, fewer ventilator-free days, and increased frequency of nonpulmonary multiple organ failure. CC-16 is a valuable biomarker of ARDS that may help predict outcome among ARDS patients with high-risk mortality.
-
Intensive care medicine · Aug 2006
Controlled Clinical TrialPhysiological responses to arm exercise in difficult to wean patients with chronic obstructive pulmonary disease.
To evaluate the effects of arm exercise with or without support of mechanical ventilation on breathing pattern, respiratory muscle pressure output, and ratings of dyspnea and arm discomfort in difficult-to-wean patients with COPD. ⋯ In tracheostomized difficult-to-wean patients with COPD arm exercise performed during unassisted respiration (trach collar) causes greater increases in respiratory rate and in respiratory muscle pressure output than arm exercise performed during pressure support ventilation. Exercise-induced dyspnea and arm discomfort are similar during assisted and nonassisted respiration.